“Can’t Intubate, Can’t Ventilate” – a fearsome phrase for all airway providers that necessitates an equally fright-inducing procedure. Cricothyrotomy is an emergency procedure where an incision is made through the cricothyroid membrane and a tube is inserted for ventilation. Although there are percutaneous techniques, this article will discuss surgical techniques which have been shown to produce more favourable success, complication rates of the procedure, as well as address some common fears associated with …
HiQuiPs: Test Result Follow-up in the Emergency Department
Introduction Test result follow-up can be especially challenging in the Emergency Department (ED) due to its multiplicity of moving parts. ED physicians are under increasing pressure when treating patients due to the challenges of high volumes of patients, pressure for quick discharges in the face of space constraints, and complexities surrounding patient handover. Test result follow-up is a process that is complex and has several steps, each with their own potential for error. …
HiQuiPs: Patient Safety Fundamentals – Patient Fall Prevention
An 85-year-old woman who lives independently at home was hospitalized three days ago for pneumonia. She has multiple comorbidities, including dementia, hypertension and diabetic neuropathy. While in hospital, the patient’s care team noticed her losing balance, and it was determined that the patient was at high risk of falling. One evening, the patient attempted to go to the bathroom independently. She put on her glasses and took the cane provided to her, as …
HiQuiPs Patient Safety Fundamentals: Reducing Central Line-Associated Bloodstream Infections
You are a resident rotating through the ICU. One of your patients is a 75-year-old female who was admitted for urosepsis (sepsis originating from the urinary tract). She required vasopressor support and had an internal jugular vein central venous catheter placed in the ED. Since admission, the patient has been improving with broad-spectrum antibiotics. However, on the 7th-day post-admission, you’re alerted that the patient is deteriorating, with tachycardia and worsening fever. You rush …
HiQuiPs: Patient Safety Fundamentals – Reducing Pressure Injuries
Hilary Weatherby is a Registered Nurse working as a Patient Safety & Quality Improvement (QI) Specialist. Hilary helps teams apply QI methodology to organization-wide projects and reviews patient safety events for the purposes of continuous quality improvement across a large, downtown Toronto, hospital system. You are a medical student seeing patients on a medicine unit at your local community hospital. One of your patients is an 81-year-old female with Parkinson’s disease who was …
HiQuiPs: Using In Situ Stress Testing to Address Latent Safety Threats
It’s a night shift, quieter than usual, though you wouldn’t say so out loud. As if the thought is enough to tempt fate, EMS rolls by. You got no patch, no heads up. “Car accident, just outside the hospital,” a paramedic calls as the patient is transferred onto the trauma stretcher. All you hear are unintelligible moans. All you see is blood streaming from a severely injured face. But the team’s already working, …